Update on AspECT in Northern Ireland
AuthorsWatson P, Gallagher C, Lawler H, Lloyd A
Departments / InstitutionsRoyal Victoria Hospital and Queen’s University Belfast.
Publication DateAutumn 2015
Barrett’s oesophagus is a recognised precancerous lesion. AspECT (Aspirin and Esomeprazole Chemoprevention Trial of Oesophageal Cancer in patients with Barrett’s oesophagus) started recruitment in 2005. It is a randomised 4×4 comparison of high dose PPI 40 mg BD Esomeprazole vs 20 mg OD and aspirin 300 mg OD vs no aspirin. The end point is high grade dysplasia (HGD)/cancer.
Recruitment closed in 2009 with 2506 Barrett’s patients in the UK and 302 (12%) of these in NI. There were 242 males, 60 females age range 23 – 81 mean 54. The aim is to follow each patient for up to 10 years with 2 yearly endoscopy and is due to finish in 2017.
12 patients have completed 10 years and all have completed 6 years. 11 have died of non-oesophageal cancer related causes and 26 are lost to follow up. 12 developed HGD/cancer (4% overall or 0.47% per patient years of follow up) at 1 month to 9 years (mean 3.4). There were 8 males (3% of males) and 4 females (6.5%). The lengths of Barrett’s ranged from 2-10cms and all were specialised intestinal metaplasia. Low grade dysplasia preceded HGD/cancer in 6. One had oesophagectomy and the rest endoscopic treatment. All are disease free at follow up.
HGD/cancer developed in this cohort at a higher rate than some recent epidemiological studies, possibly because of careful follow up and all were successfully treated. The effects if any of chemoprevention await publication of the full study.
Event takes place on October 14, 2021
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